Appendicitis: Accurate Diagnosis Or No Radiation

Amid the mounting concern about radiation exposure and future increases in cancer rates comes a report from Washington State describing the benefits of imaging, particularly CT scanning, for the diagnosis of appendicitis.

The authors collected data from some 55 hospitals of all types and sizes over a six-year period for more than 19,300 patients older than age 15; 91% of patients underwent one or more imaging studies. There were 16,852 (87.2 percent) CT scans, 1160 (6.0 percent) ultrasounds and 108 MRIs (0.6 percent) with 1677 (8.7 percent) patients having no imaging.

If a patient had an imaging study, the rate of normal appendix removal was only 4.5 percent compared to 15.4 percent for those who were not imaged, p < 0.001. Stated another way, on multivariate analysis a patient who had no imaging was over 3 times more likely to have a normal appendix at surgery. Only 4.1 percent of those undergoing CT scan had a normal appendix compared to 10.4 percent of those who had only an ultrasound, p < 0.001.